Extra! Extra! Read All About It! Pasteur “Cures Hydrophobia”

The date is October 30, 1885, and news has come from a scientific conference in France where Dr. Louis Pasteur has announced that he has found a way to prevent rabies infection in someone who was exposed to the disease from a bite of a rabid dog. Young Joseph Meister had been bitten 14 times by a dog exhibiting the signs of rabies. His mother took him to Dr. Pasteur in hopes that Dr. Pasteur — who was known to be working on rabies — could do something to save her child.

Rabies was called hydrophobia at the time because animals and people who were exhibiting signs of rabies would often not want to drink water because it was painful. Their salivary glands, where the virus was replicating, would be inflamed and produce an excess of saliva, making swallowing difficult and causing the victim to have unquenchable thirst simultaneously. Rabies is quite a horrible way to die, and almost all cases are fatal, except for one or two documented human cases where heroic medical measures saved their lives.

In Pasteur’s era, rabies was rampant due to the number of stray dogs and other wildlife in the cities. Cattle were affected after being attacked by infected animals. As a result of the need to cure or prevent rabies, Dr. Pasteur observed the natural progression of rabies in different animals and performed experiments to see if the virus — which at the time was unknown — could somehow be attenuated in the same way that he had attenuated bacteria causing chicken cholera. This required a lot of work by Pasteur and his colleagues.

They would serially infect rabbits in their laboratory and then — once those rabbits died of rabies — take the rabbits’ spinal cord tissue and infect another generation of rabbits. Done enough times, this guaranteed that the tissue was highly infectious. They then took the tissue and dried it in hopes that the drying process would kill or attenuate the virus, and it did. They observed that injecting healthy animals with the dried tissue did not cause disease, and that the animals injected would show some immunity to rabies.

By the time that Joseph Meister was brought to Dr. Pasteur, the evidence was clear that something was going on with animals inoculated with the dried tissue. As it was confirmed that the dog that attacked Joseph was rabid, Dr. Pasteur and colleagues weighed whether to experiment on Joseph and decide to go ahead. One hundred days after the last inoculation, Joseph was alive and not showing any signs of rabies. As he reported these findings to the French National Academy of Medicine, the crowd is said to have given him “an enthusiastic ovation from both the Academy itself and the public who were present.” As part of his presentation, Dr. Pasteur advocated for establishing a steady supply of spinal cord tissue, dried out, from infected rabbits to have inoculations ready for people who were attacked by rabid animals.

According to the Museum of American History:

“Shortly after Pasteur successfully treated his first rabies patient in France, four boys from Newark, New Jersey, were bitten by a dog suspected of carrying the disease. A national campaign was launched to send the boys to Pasteur for treatment, and the story became a media sensation. It seemed that the entire nation was following the boys, who went to France for Pasteur’s treatment and returned home as “heroes,” even taking a subsequent tour of American cities.

This event helped launch the establishment of “Pasteur Institutes” in many American cities in order to provide rabies vaccines and treatment closer to home. Even so, many people would have to travel, and bear the time and expense of an extended stay, to receive the treatment that required several weeks of injections.

In 1911, Philadelphia drug company H. K. Mulford announced a new rabies treatment kit that could be shipped directly to doctors and was simple enough that “physicians who have had no previous experience may successfully apply it.” The kit is a reminder that even the best medicine is of no consequence if it is not available and affordable.

The treatment consisted of 25 injections of rabies vaccine: three on the first day, two on the second, two on the third, and one each day after for 18 days. Each dose was slightly stronger, or more virulent, than the preceding, so that the body could build up immunity. Because the vaccine had to be “fresh” to be effective it could not be stocked by druggists. Subsequent daily doses were shipped directly from Philadelphia in a special Caloris vacuum bottle (not unlike your coffee thermos).”

And here is how The New York Times reported Pasteur’s presentation to the Academy:

“Dr. Louis Pasteur’s experiments have resulted in a most brilliant success. At perhaps the most important sitting held by the Academy of Sciences Dr. Pasteur thus described the process of cure by means of a rabbit inoculated with the fragment of a tissue taken from the spine of a rabid dog. The incubation of the poison occupied 15 days. As soon as the first rabbit inoculated was dead a portion from its spinal marrow was in turn inoculated into a second rabbit, and so on until 60 rabbits had been inoculated. At each successive inoculation, the virus increased in potency, and the last period of incubation did not occupy more than seven days.

Having ascertained that exposure to dried air diminished the virus, and consequently reduced its force, Dr. Pasteur supplied himself with a series of bottles of dried air. In these bottles he placed portions of inoculated spinal marrow at successive dates, the oldest being the least virulent and latest the most so. For an operation Dr. Pasteur begins by inoculating his subject with the oldest tissue and finishes by the injection of a piece of tissue whose bottling dates back only two days and whose period of incubation would not exceed one week. The subject is then found to be absolutely proof against the disease.”

The article continues with the story of Joseph Meister and ends thus:

“One of the leading doctors present remarked that the question was whether a man cured of hydrophobia could suffer from a second bite. In other words, whether the inoculation of virus was a guarantee against hydrophobia. In answer Dr. Pasteur states that the malady is transmissible only by bite. If, therefore, by a general compulsory inoculation of dogs for several generations dogs had been made incapable of hydrophobia, the malady would have disappeared and there would be no occasion to ask whether inoculation had a permanent effect or not. As to the origin of hydrophobia, Dr. Pasteur says nobody in the world can explain its primal causes. As he remarked — perhaps out of politeness — his theory will require study by the profession in order to make it practical, but he emphatically stated that the cure for hydrophobia had been found.”

Today, human cases of rabies are still found in places where the vaccine is not readily available, almost 135 years after Pasteur’s experiment on Joseph Meister. In the United States, human rabies cases are very rare because of a coordinated effort between state and local health departments to vaccinate wild and domesticated animals, surveillance programs to identify and isolate rabid animals and rapid delivery of rabies vaccine to anyone possibly exposed to rabies (though sometimes at a great financial cost).

Here is a video about one wildlife vaccination campaign by the United States Department of Agriculture:

Avatar

Author: René F. Najera, DrPH

I am the editor of the History of Vaccines site, an online project by the College of Physicians of Philadelphia. All opinions expressed on these blog posts are not necessarily those of the College or any of my employers. Check out my professional profile on LinkedIn: https://www.linkedin.com/in/renenajera Feel free to follow me on Twitter: @EpiRen

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.